CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Sacred Heart Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $19,155
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.81x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Sacred Heart Hospital is $19,155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 0.81x the Medicare baseline. Located in 5151 N 9Th Ave, Pensacola, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$19,155

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)
Insurance Median: $19,155 (81%)
Ins. Median: $19,155 (81% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $23,503.93 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Vista Coventry State Of Florida $7,300 31%
Blue Cross Blue Shield $10,172 - $19,155 43%
Cigna $10,470 45%
Pcc Employee $10,815 46%
Aetna $16,275 - $20,868 69%
UnitedHealthcare $16,961 - $20,463 72%
Blue Mcr Replacement $20,260 86%
Facility Billing - Op $20,260 86%
Medicare (plans) $20,260 86%
Wellcare $20,260 86%
Healthspring Mcr Replacement $20,665 88%
Humana $20,868 89%
Smarthealth $28,364 121%
Oscar Health Plan $32,416 138%
Ambetter / Centene $33,429 142%
Occunet $45,585 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5151 N 9Th Ave, Pensacola, FL 32504
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals